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I am a 28 year old asian male who has been experiencing a plethora of gastrointestinal issues for probably at least the past 2 years. I've been managing until just recently, when I noticed some dark, tarry stools and prompted a visit to my doctor. I have been having diarrhea and constipation (but mostly diarrhea) for quite some time now. Often it's after eating a greasy meal and sometimes not. I find myself having to use the toilet more frequently after meals, with loose and sometimes thin stools. I don't recall when the last time I actually felt hungry, as I constantly feel bloated after a meal with quite a bit of burping and gas. Over the past year, a few times I've had heart palpitations and elevated blood pressure. Also I felt like I had some heart pain, which went away after a few hours. I've also noticed that at times when trying to defecate, I would have incomplete episodes, trying but with nothing coming out. Also I've noticed small amounts of red blood on the toilet paper after wiping and after taking a picture of my underside with my camera, it appears to be either from hemorrhoids or anal fissures due to visible cuts on my perineum area. Also my anus and perineum has been itchy for some time now, which i have been treating with a corticosteroid cream, but I suspect that it's probably a result from the increased bouts of diarrhea i've been experiencing. I've noticed some weight loss over several months (from about 75 kg to 71-72) but i've been exercising occasionally, and maybe due to my recent slight loss of appetite, i've lost a bit of weight. I've also been fatigued quite a bit (even with 6-7 hours sleep every night). After dinner sometimes, I get overwhelmed with an extreme tiredness. Also i've been driving long distance (12 hours return) almost every weekend to see my girlfriend. My most recent blood tests indicated that my cholesterol was borderline high (5.5) and my B12 levels was borderline low (177). According to my doctor, my liver function tests and Complete Blood Cell Count tests were okay. Roughly 2 years ago, I was treated for appendicitis and had my appendix removed. Also over the past 5 years or so, i've been taking antacids (pepcid ac, and now zantac) prior to drinking alcohol to reduce the effects of flushing. I understand now that prolonged use of antacids can reduce stomach acids, which potentially can reduce my B12 levels due to decreased production of intrinsic factor. I am also not sure if this prolonged use of H2 blockers may have allowed an increase in bacteria inside my stomach and digestive tracts including perhaps the Helicobacter Pylori bacteria. All of the symptoms that I am currently experiencing point to either Stomach or Colon cancer. Also there does not appear to be any family history of either types of cancer and lower risks factor due to my age, I can't help but be nervous due to all the symptoms that line up. My doctor has requested for me to do some additional tests including a FOBT, Hepatitis, Celiac Disease, Coagulation test as well as an appointment with a gastrointestinal surgeon. Can someone please help me understand what my body is trying to tell me? I sincerely hope that it's nothing serious.

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It's kinda hard to avoid finding the worst possible options like cancer and fitting them alongside all these gastrointestinal symptoms because these symptoms - not only in your case - are somewhat diffused and can be linked to numerous conditions. And most of them are not cancer. I think that seeing gastrointestinal surgeon is probably the best because he will be able to see what is going on with your stomach (and if it was H. Pylori, it could have caused stomach or duodenal ulcer which could explain why you had tarry stools), but also gallbladder. And when you eat, what does your meal look like?
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Well for dinner i had fried rice, fried egg, red capsicum, green beans and a few baked chicken wings. Several hours later, i experienced diarrhea. This is despite eating a fiber rich breakast and lunch along with probiotics and yogurt.
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Fiber rich diet maybe is not the best thing right now when you have problems with diarrhea. Not that you should completely eliminate them, but maybe low fiber diet would be better now because your intestines already are somewhat overactive. As far as the dinner is concerned, the only thing that could have caused problem is red pepper (it might irritate your stomach so that it starts to produce more acid which then causes other symptoms). But that still isn't an explanation for intestinal and bowel problems. The food you ate was fried, but I doubt that it was so fatty your gallbladder couldn't handle that. However, it still is worth checking out as well because symptoms you are experiencing do fit in with those lower gallbladder function would cause.
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Thanks, i'll mention that to my doctor on my next visit. The reason I was eating a fiber rich diet was the requirements for my fecal occult blood test. I really hope that it's nothing serious. At this stage, i'm hoping it's either a gallbladder stone, peptic ulcers or gastritis (H. Pylori infection) and for my low B12 readings, that it's related to either my prolonged use of H2 blockers and/or an H. Pylori infection/peptic ulcers. At times I can envisage the doctor giving me the bad news, as my life flashes before me.
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The GI confirmed via an endoscopy and colonoscopy along with a biopsy sample from the stomach and small intestine that everything looked normal (biopsies were negative for helicobacter pylori and celiac's disease) aside from inflamation in my stomach. He has prescribed me with a proton pump inhibitor ie nexium for a month to reduce my stomach acid to allow healing. He has also advised me to stay away from spicy foods, stress, and alcohol. Also I've temporarily stopped consumption of coffee due to it's acidic nature (also trying to stay away from anything else acidic) as well as stopped taking Zantac and alcohol. I've been taking b12 1000 micrograms sublingual tablets 3 times a week for a few months to see if my b12 levels will go back up.

At this stage, I will have a followup in 2 months time with the GI. As I do not have helicobacter pylori, I am interested to see what could have caused the gastritis in the first place (ie stress, spicy foods, alcohol, zantac etc). Also hopefully once this issue is resolved, I can gain the unusual amount of weight back that I have lost thus far.

Thanks for your responses to date, they have been very helpful and reassuring.

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